摘要:这3名患者在取得稳定的分子学缓解之后(融合基因转阴PCRU)停用达沙替尼。1名患者复发,另外两名患者在1年后仍保持了PCRU。以前说过,达沙替尼确实可以提高免疫力,希望今后能获得更多的相关研究报告。8 X# V: w* L; E7 ]
关于这个研究值得注意的是,这三名患者都是服用格列卫失败后转用达沙替尼的,也即他们对格列卫是耐药的。这与法国的格列卫停药研究又有所不同,那个研究中的患者都是对格列卫反应良好的。希望医生们能扩大研究长期观察,看看停用达沙替尼是否能持久不复发。0 E( C- Q4 J& R- h$ Y& g8 l% \5 r
5 @4 A. k' F, R作者:来自澳大利亚
$ L5 K/ g& y, y# g1 m4 |$ ?来源:Haematologica. 2011.8.9.
`: D# [' T! x/ @/ PDear Group,
% E4 o2 \' g; N4 j- k2 {7 t7 D7 a8 c/ E1 I1 r0 Q: N/ [
Some of you are on Dasatinib (Sprycel) and we wish to give news on all CML
- O6 L+ p5 O4 }$ T I) `therapies. Here is a report from Australia on 3 patients who went off Sprycel+ K( ]& s1 v+ x# u. F
after stable molecular response (PCRU). 1 patient relapsed but 2/3 patients# F4 [ r, P" o2 L
remain in stable PCRU at the 1 year mark. Some of you may remember that Sprycel
- l1 v, _3 y4 g- O. udoes spike up the immune system so I hope more reports come out on this issue.
9 U* {1 q/ H- C% f; }( ^$ |) k( T6 Q0 D& C3 M- y: |7 S y8 s# r
The remarkable news about Sprycel cessation is that all 3 patients had failed
# G0 G, F. l# i7 {Gleevec and Sprycel was their second TKI so they had resistant disease. This is6 j4 h/ T$ p+ o
different from the stopping Gleevec trial in France which only targets patients, r6 a$ ?0 ^. p. I- h; g
who have done well on Gleevec.
) `* |1 O3 n, h% p4 u
$ f/ e, B6 q8 kHopefully, the doctors will report on a larger study and long-term to see if the5 G( A, o. a1 Z* A9 ]
response off Sprycel is sustained.* D& `; m7 ~+ n+ c& i. n
$ ?& U4 ?' @( I$ y; ^Best Wishes,
& i/ D: p6 |2 w# I9 lAnjana
6 Q4 U" @, Q( F; x( @
7 j* ~- h' x# q: J2 ^
2 ?) S( j0 E/ K8 ^
. M0 E7 R/ c+ }# ~ e5 |+ `Haematologica. 2011 Aug 9. [Epub ahead of print]
3 a% S& D: A/ R7 J, Z* [& n- VDurable complete molecular remission of chronic myeloid leukemia following1 f3 F4 R- N4 V% o: W
dasatinib cessation, despite adverse disease features.
2 j9 X2 `' X" D! c* IRoss DM, Bartley PA, Goyne J, Morley AA, Seymour JF, Grigg AP.
: Z# M' ^5 W6 K0 i9 BSource# P3 S4 ]2 Q! r! ?( ]; p
Adelaide, Australia;
4 A) u+ Z% o& K( K+ Z5 ]3 e* j9 E" @& |. V0 \
Abstract2 f$ `" a: N* t/ _
Patients with chronic myeloid leukemia, treated with imatinib, who have a
n6 y% u, z$ W: [7 F+ [" xdurable complete molecular response might remain in CMR after stopping( Q- d2 Y; X% S, H- Z' l
treatment. Previous reports of patients stopping treatment in complete molecular; c0 `" Z) ]( D
response have included only patients with a good response to imatinib. We% J* X/ Q: S8 \7 d/ ?
describe three patients with stable complete molecular response on dasatinib
8 U; B$ m" t( Dtreatment following imatinib failure. Two of the three patients remain in3 F6 J' C3 L0 a6 t }
complete molecular response more than 12 months after stopping dasatinib. In
" A" {/ v) G& H+ C& Q) q7 pthese two patients we used highly sensitive patient-specific BCR-ABL1 DNA PCR to L( {$ D2 a c( D+ v8 v* w
show that the leukemic clone remains detectable, as we have previously shown in
! y! X# F. f0 h& t% a9 ~imatinib-treated patients. Dasatinib-associated immunological phenomena, such as& C$ y6 C; S+ E5 u& y# [
the emergence of clonal T cell populations, were observed both in one patient& e3 O$ C. F- v; s' [# {5 d* m# c
who relapsed and in one patient in remission. Our results suggest that the
# p+ L6 b6 q' `2 U9 \8 dcharacteristics of complete molecular response on dasatinib treatment may be
8 H/ Q1 _: v1 n* }5 O! e3 Fsimilar to that achieved with imatinib, at least in patients with adverse
: Y# H; P( v% T# M6 I8 m+ c' cdisease features.
3 v% B' ]2 M/ h3 I; p/ Z+ r |